The clinicians at Newaygo County Mental Health periodically contribute articles to help educate, enlighten and increase awareness of mental health issues.
Emily Derks, LMSW; Kayla McKnight LLMSW; Christina Bitson, Intern
“I thought I would have to teach my child about the world. It turns out I have to teach the world about my child. FASD is its own world.”-Anonymous
Fetal Alcohol Spectrum Disorder (FASD) is a mental health disorder involving Prenatal Alcohol Exposure, meaning an embryo is exposed to alcohol while in the mother’s womb (American Psychiatric Association (DSM-5), 2013, p.798-801). According to the DSM-5, no amount of alcohol can determine the adverse effects of neurocognitive impairments. Children whose symptoms seem less severe are at risk to struggle more socially and academically because they have a “hidden disability” and may not readily qualify for extra support services in the school. Additionally children with unknown fetal alcohol exposure are viewed as oppositional or defiant.
The psychological dimensions of FASD are many including having hope for your child and the relationships your child will foster with your family and the community. No matter the age of your child, you are not alone when it comes to accepting the intrusion of your child’s disability and how you feel about grieving this loss. Feeling disconnected is common. It can be helpful to recognize the duality of joy and grief that is ever present from the journey that comes with parenting a child with FASD.
Your clinician should support the challenges within the parent-child relationship including potential guilt and the ups and downs that influence your bond with your child. Therapy can help provide a space to explore your child’s disability and process through the most challenging moments that you and your child are experiencing. You are not alone if your child is lacking benefit from natural consequences or reward systems to promote good behavior. It is commonly reported that children with this diagnosis never really look the same, but themes of ensuring safety, and trying to monitor the child's mood and impulsivity is constant. Children with FASD cannot be compared to children who do not have this brain damage.
Prevalence & Barriers to Diagnosis
FASD has a prevalence rate between 1.13% and 5% (1 in 88 to 1 in 20 individuals), which makes it more common than Autism Spectrum Disorder and Down Syndrome. (May et. al., 2018). Despite how common this disorder is, there are many barriers that prevent children from being properly diagnosed and treated. One such barrier is the presence of mental health stigma. Stigma is a complex social process by which a person or group of individuals are considered less acceptable due to a specific trait or behavior (Alcohol and Drug Foundation, 2020). Since FASD is a “hidden disability”, often the challenges of the disorder go unnoticed and help may not be received (Green et al., 2016).
Parents of children with FASD often feel blamed for their child’s disability. Pregnant women who drink alcohol may receive stigma from health care providers. Prolonged stigma often contributes to feelings of lowered self-esteem, depression, feelings of shame, and fear of losing one’s child. Recognizing these fears, it is understandable that some individuals may not talk with health care professionals. However, not discussing your struggles often makes the problem worse. Overall, stigma may prevent individuals from receiving appropriate health care services.
The National Association on Fetal Alcohol Syndrome (NOFAS) (2020), states that “prenatal alcohol exposure is the nation’s leading preventable cause of developmental disabilities and birth defects”. This is good news. FASD can be prevented! Raising public awareness about the risk that prenatal exposure to alcohol has on a developing child is one way we all can help with prevention. However, the only true way to prevent FASD is for women and men to abstain from alcohol consumption before and during conception and for women to abstain throughout pregnancy.
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